In partial fulfilment of the subject

NRS 1101 – Theoretical Foundations in Nursing

Submitted by:

Frusa, Jasmine

Villaluna, Maria Luisa C.

Submitted to:

Professor Ronie M. Tiamson, RN, MAN, RM

August 24, 2018

 MYRA ESTRIN LEVINE (1920- 1996)

The Conservation Model

Nursing’s role in conservation is to help the person with the process of “keeping

together” the total person through the least expense of effort. Levine (1989) proposed

the following four principles of conservation:

The conservation of energy of the individual

1. The conservation of the structural integrity of the individual.

2. The conservation of the personal integrity of the individual.

3. The conservation of the social integrity of the individual.

“The conservation principles do not, of course, operate singly and in isolation from each

other. They are joined within the individual as a cascade of life events, churning and

changing as the environmental challenge is confronted and resolved in each individual’s

unique way. The nurse as caregiver becomes part of that environment, bringing to every

nursing opportunity his or her own cascading repertoire of skill, knowledge, and

compassion. It is shared enterprise and each participant is rewarded.” (Levine, 1989)

MAJOR CONCEPTS

 Environment - includes both the internal and external environment.

 Three Aspects of Environment Drawn upon Bates’ (1967) Classification:

The operational environment consists of the undetected natural forces and that

impinge on the individual.

The perceptual environment consists of information that is recorded by the

sensory organs.

The conceptual environment is influenced by language, culture, ideas, and

cognition.

 Person - is the unique individual in unity and integrity, feeling, believing, thinking,

and whole.

 Health - is the pattern of adaptive change of the whole being. Nursing - is the

human interaction relying on communication, rooted in the organic dependency

of the individual human being in his relationships with other human beings.

 Adaptation - is the process of change and integration of the organism in which

the individual retains integrity or wholeness. It is possible to have degrees of

adaptation.

 Conservation - includes joining together and is the product of adaptation

including nursing intervention and patient participation to maintain a safe

balance.
  Personal integrity - is the person’s sense of identity and self-definition. Nursing

intervention is based on the conservation of the individual’s personal integrity.

 Social integrity - is life’s meaning gained through interactions with others.

Nurses intervene to maintain relationships.

 Structural integrity - Healing is the process of restoring structural integrity

through nursing interventions that promote healing and maintain structural

integrity.

SUBCONCEPTS

Three Concepts of Adaptation

(a) Historicity

Adaptation is a historical process, responses are based on past experiences, both

personal and genetic

(b) Specificity

Adaptation is also specific. Each system has very specific responses. The physiologic

responses that “defend oxygen supply to the brain are distinct from those that maintain

the appropriate blood glucose levels.” (Levine, 1989)

(c) Redundancy
Although the changes that occur are sequential, they should not be viewed as linear.

Rather, Levine describes them as occurring in “cascades” in which there is an interacting

and evolving effect in which one sequence is not yet completed when the next begins.

Energy conservation

- Nursing interventions based on the conservation of the patient’s energy.

Holism

- The singular, yet integrated response of the individual to forces in the environment.

Homeostasis

- Stable state normal alterations in physiologic parameters in response to

environmental changes; an energy sparing state, a state of conservation.

Modes of communication

- The many ways in which information, needs, and feelings are transmitted among the

patient, family, nurses, and other health care workers.

Therapeutic interventions

- Interventions that influence adaptation in a favorable way, enhancing the adaptive

responses available to the person.

ASSUMPTIONS

1. Assumptions About Individuals

  Each individual “is an active participant in interactions with the environment…

constantly seeking information from it.” (Levine, 1969)

 The individual “is a sentient being and the ability to interact with the environment

seems ineluctably tied to his sensory organs.”

 “Change is the essence of life and it is unceasing as long as life goes on.

Change is characteristic of life.” (Levine, 1973)

2. Assumptions About Nursing

 “Ultimately the decisions for nursing intervention must be based on the unique

behavior of the individual patient.”

 “Patient centered nursing care means individualized nursing care. It is predicated

on the reality of common experience: every man is a unique individual, and as

such he requires a unique constellation of skills, techniques and ideas designed

specifically for him.” (Levine, 1973)

Relationships

1. Conservation of energy is based on nursing interventions to conserve through a

deliberate decision as to the balance between activity and the person’s available

energy.

Ex: Making sure one’s client gets enough sleep and balanced nutrition.
 2. Conservation of structural integrity is the basis for nursing interventions to limit

the amount of tissue involvement.

Ex: Helping the client stay sctive and promoting good personal care.

3. Conservation of personal integrity is based on nursing interventions that permit

the individual to make decisions for himself or participate in the decisions.

Ex: Giving clients choice in how to receive care.

4. Conservation of social integrity is based on nursing interventions to preserve the

client’s interactions with family and the social system to which they belong.

Ex: Making a pastor available to maintain religious ties during hospitalization.

All nursing interventions are based on careful and continued observation over time.

STRENGTH/ WEAKNESSES

Strengths:

Levine has interrelated the concepts of adaptation, conservation and integrity in a way

that provides a nursing view different from that of the adjunctive disciplines with which

nursing shares these concepts.

Levine’s work is logical. One thought or idea flows from the previous one and into the

next.
Weakness:

There are many concepts with comparatively unspecified relationships and unstated

assumptions.

ANALYSIS

Although there are many concepts similar to that of other nursing theories, Levine’s

concept of energy conservation makes it unique in guiding nursing actions.

Borrowed concepts from Bates regarding Levine’s view with the environment were not

translated into how it affects the individual. The necessity of connecting incorporated

concepts is crucial when trying to develop a model for nursing so as to be applied to

human care.

The concept of conservation, adaptation and integrity can be applied to any age group

since every individual has the need to expend and reserve bodily energy.

The operational definition of homeostasis by Levine is in question since to achieve

homeostasis, energy is continuously being used by the body thus her statement that

homeostasis is an energy sparing state is quite vague in nature. Rewording might be

helpful in this part of her model.